Medical school: LINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduated: 2012
NPI: 1447595608
Practice Locations (2)
LIFESOURCE OF NORTH CAROLINA
3205 RANDALL PKWY, SUITE 105
WILMINGTON, NC 284032565
9107429243
LIFESOURCE PRIME INC
3205 RANDALL PKWY, SUITE 105
WILMINGTON, NC 284032565
9107429243
Source: CMS National Downloadable File, September 2026.